妊娠期糖尿病患者孕6~14周血清CTRP3、FGF19及SHBG的变化及预测价值  

Changes and predictive value of serum complement C1q/tumor necrosis factor-related protein 3,fibroblast growth factor 19 and sex hormone-binding globulin in patients with gestational diabetes mellitus during 6-14 weeks of pregnancy

作　　者：史少文 魏敬艳 郭丽魁[1] 许红蕊 SHI Shaowen;WEI Jingyan;GUO Likui;XU Hongrui(Department of Obstetrics,Qinhuangdao First Hospital,Qinhuangdao 066000,Hebei,China)

机构地区：[1]秦皇岛市第一医院产科,河北秦皇岛066000

出　　处：《中国性科学》2024年第1期110-115,共6页Chinese Journal of Human Sexuality

基　　金：秦皇岛市科学技术研究与发展计划项目(202004A121)。

摘　　要：目的探讨妊娠期糖尿病(GDM)患者孕6~14周血清补体C1q/肿瘤坏死因子相关蛋白3(CTRP3)、成纤维细胞生长因子19(FGF19)及性激素结合球蛋白(SHBG)的变化及预测价值。方法回顾性分析2019年6月至2022年10月在秦皇岛市第一医院分娩的684例单胎妊娠孕妇的临床资料。统计GDM发生率,根据是否患有GDM分为病例组(n=266)和对照组(n=418)。比较两组CTRP3、FGF19及SHBG水平,并分析其联合预测GDM的价值,采用单因素和多因素Logistic回归分析影响GDM发生的危险因素。结果684例孕妇GDM发生率为38.89%(266/684)。与对照组比较,病例组CTRP3、FGF19及SHBG水平更低(P<0.05)。受试者工作特征(ROC)曲线结果显示,CTRP3、FGF19及SHBG联合预测GDM的曲线下面积(AUC)高于单项预测(P<0.05)。两组年龄、孕前体重指数(BMI)、不良孕产史、糖尿病家族史、妊娠期高血压、月经周期紊乱、CTRP3、FGF19、SHBG比较,差异具有统计学意义(P<0.05);两组孕次、产次比较,差异无统计学意义(P>0.05)。年龄≥35岁、孕前BMI≥24 kg/m^(2)、不良孕产史、糖尿病家族史、CTRP3<417.82 ng/L、FGF19<139.23 pg/mL、SHBG<429.59 mmol/L是影响GDM发生的独立危险因素(P<0.05)。结论GDM患者孕6~14周CTRP3、FGF19及SHBG水平均会下降,通过CTRP3、FGF19及SHBG联合预测GDM具有较高的应用价值。Objective To explore the changes and predictive value of serum complement C1q/tumor necrosis factor-related protein 3(CTRP3),fibroblast growth factor 19(FGF19)and sex hormone-binding globulin(SHBG)in patients with gestational diabetes mellitus(GDM)during 6-14 weeks of pregnancy.Methods The clinical data of 684 single pregnancy women undergoing delivery in Qinhuangdao First Hospital from June 2019 and October 2022 were retrospective analyzed.The incidence of GDM was statistically analyzed and divided into case group(n=266)and control group(n=418)according to presence or absence of GDM.The levels of CTRP3,FGF19 and SHBG in the two groups were compared,and the predictive value of their combined detection for GDM was analyzed.The risk factors of GDM occurence were analyzed by univariate and multivariate Logistic regression analysis.Results In the 684 pregnant women,the incidence of GDM was 38.89%(266/684).Compared with control group,levels of CTRP3,FGF19 and SHBG were lower than that in case group(P<0.05).The results of receiver operating characteristic(ROC)curves analysis showed that the area under ROC curve(AUC)of CTRP3 combined with FGF19 and SHBG for predicting GDM was higher than that of single prediction(P<0.05).There were significant differences in age,progestational body mass index(BMI),adverse pregnancy history,family history of diabetes mellitus,gestational hypertension,menstrual cycle disorder,CTRP3,FGF19 and SHBG between the two groups(P<0.05),but there was no significant difference in gravidity and parity between the two groups(P>0.05).Age≥35 years,progestational BMI≥24 kg/m^(2),adverse pregnancy history,family history of diabetes mellitus,CTRP3<417.82 ng/L,FGF19<139.23 pg/mL and SHBG<429.59 mmol/L were independent risk factors of GDM(P<0.05).Conclusions The levels of CTRP3,FGF19 and SHBG are all decreased in GDM patients during 6-14 weeks of pregnancy.The combined prediction of GDM by CTRP3,FGF19 and SHBG has higher application value.

关 键 词：妊娠期糖尿病 孕6~14周 补体C1q/肿瘤坏死因子相关蛋白3 成纤维细胞生长因子19 性激素结合球蛋白 预测价值 

分 类 号：R714[医药卫生—妇产科学]